Not so long ago, people who found themselves struggling with mental health issues kept it to themselves. Mental illness has long been stigmatized in a way that physical illness simply is not. Fortunately, the taboo on talking about mental illness is starting to fall away, with athletes and celebrities openly discussing their struggles and encouraging others to seek help.
Even with these trends, there is one group that may be suffering more from mental health issues and talking about it less: senior adults. Older adults are most likely to see mental illness as something weak or shameful, or to feel that they should be able to deal with it themselves. Unfortunately, this type of thinking makes it more difficult to get the help that could really make a difference.
According to the CDC, about 20% of adults 55 and older experience some kind of mental health issue. Common concerns include depression, anxiety, and severe cognitive disorders, such as dementia. Of these, depression is the most prevalent.
Depression can both stem from disease (33% of heart attack survivors suffer from depression, a much higher rate than in the general population); and complicate existing chronic disease. This can create a spiral: depression may lead to diminished overall health; physical illness leads to deepened depression, and on and on. Depressed seniors tend to make more ER and doctor visits, take more medication, and stay longer in the hospital when they are admitted.
While it’s not necessarily clear that depression or mental health issues directly cause those outcomes, rather than simply being associated with them, it is clear that mental health awareness for seniors is essential to promoting good health—physically and mentally. Good brain health is part of good overall health.
The percentage of adults who exhibit symptoms of depression does increase with age, but depression is not a normal and unavoidable part of aging. Most depressive symptoms can be treated, and the failure to do so can lead to devastating consequences: older men have the highest suicide rate of any age group, and the suicide rate in men aged 85 and up is about four times that of the general population.
Isolation and mental health concerns are linked at all ages, and social isolation is especially likely to affect the mental health of seniors. Unfortunately, the COVID-19 epidemic has forced many seniors to isolate from friends, family, and neighbors. While technology makes it easier for many of us to connect during the pandemic, some seniors either lack the technology or comfort with using it. And in any case, a screen is a poor substitute for a leisurely meal with extended family, a card gane with friends, or a grandchild’s hug.
Depression caused or worsened by isolation isn’t the only COVID-related stress affecting mental health for seniors. The pandemic itself is a huge source of stress; seniors have been disproportionately affected in terms of serious illness and death from the coronavirus. Unrelenting anxiety about contracting the illness or about loved ones’ safety in the pandemic takes a toll on seniors’ mental health as well. Washtenaw County provides some helpful resources for protecting mental health during COVID-19.
The enforced separation required by COVID-19 may not only make mental health issues worse for seniors, it may also make it harder for loved ones to pick up on signs of mental illness. These signs include:
It can be difficult for younger family members to probe deeper with older relatives when these signs of mental health problems appear. Part of the issue may be a reluctance to violate the senior’s privacy.
Many adults have an image of their parents, even as they age, as strong, even invincible. Probing too deeply into struggles an older parent is having can be deeply uncomfortable; we all want to believe that our parents are okay, even if the evidence suggests otherwise.
Knowing what we do about seniors’ general reluctance to talk about mental health (and often, their unwillingness to burden their kids), you can’t assume that if your parents were having a problem that they would tell you or reach out for help. As difficult as it may be, you may have to start the conversation, or pick up on indirect clues that your family member is struggling.
Your loved one may be trying to work up the courage to talk to you about their depression or other mental health issues. If you fail to “listen between the lines,” they may hesitate to raise the issue again. For instance, if a senior expresses a wish to be dead or says everyone would be better off without them, don’t brush off the comment by saying, “You don’t mean that!” It’s better to observe that they sound sad, or worried that they are a burden. It may be a relief to hear their feelings reflected back to them—which may make them more likely to open up.
It is also okay, if you are worried, to ask, “Have you been thinking about suicide?” The answer may be difficult or painful to hear, but hearing it is the first step to getting the help your loved one needs. A senior’s primary care physician is always a good place to reach out to for guidance on getting appropriate mental health treatment for them. For more immediate concerns, you may want to call a mental health hotline, such as the one provided in these mental health resources from the State of Michigan.
If you have questions about seniors and mental health that were not answered in this article, please contact our law office for more help.